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OPINION

Work for Medicaid? Health care ensures people are well enough to get a job

The Register's editorial
Published 3:41 p.m. CT Nov. 14, 2017

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The federal agency that oversees health insurance programs for tens of millions of American consumers has a new leader. Vice Pence has sworn in Seema Verma as administrator of the Centers for Medicare and Medicaid Services. (March 14)

Medicaid employment requirements are unnecessary, politically-driven

President Lyndon Johnson signs the Medicare Bill into law while former President Harry S. Truman observes during a ceremony at the Truman Library in Independence, Missouri, in 1965.(Photo: AP Photo)

President Lyndon B. Johnson may have rolled over in his grave when Seema Verma quoted him last week. The administrator of the Centers for Medicare and Medicaid Services was outlining her philosophy on Medicaid in a speech to state health care officials.

She announced states will, for the first time, be allowed to impose work requirements on low-income Americans who rely on the government health insurance. Verma is catering to a handful of Republican governors who want to require employment or participation in job programs to qualify for coverage.

“If we are going to live up to the promise of Medicaid, we need to do more than simply pay for health-care services,” she said. “It’s why we believe community engagement requirements are actually in the spirit of Johnson’s idea.”

Well, not quite.

Johnson was pretty clear in the 1965 speech he delivered when signing Medicaid and Medicare into law. There was no inkling he wanted to make access to health care contingent on work. Instead, he recognized people need care to be well enough to secure and hold a job.

“Millions of our citizens do not now have a full measure of opportunity to achieve and to enjoy good health,” he said, quoting and crediting Harry Truman for his dedication to creating the health insurance programs. “Millions do not now have protection or security against the economic effects of sickness. And the time has now arrived for action to help them attain that opportunity and to help them get that protection.”

Help them attain the opportunity. We do that by providing health insurance so those suffering from illness can see a doctor and be healthy enough to pursue opportunities —not require them to work to get care.

If only the Trump administration would truly embrace Truman and Johnson's philosophy on health care. Officials should reread the 1965 speech as well as several others Johnson gave in which he talked about helping the sick, lifting people out of poverty and cultivating an ethic of compassion in this country.

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Contrast that with Verma's focus last week on state innovation, a misguided Obama administration and Medicaid not intending to help “able-bodied adults.” There was nothing that evoked Johnson or Truman's ideals. And nothing inspiring.

She was giving a nod to a few politicians who want to portray the poor as lazy. Those who advocate for work requirements in Medicaid point to studies showing such mandates in welfare programs increase labor force participation and lower poverty rates.

But Medicaid is not welfare. It is health insurance. People use it to get medication and care, not pay rent or buy televisions.

So it’s unclear what Verma is trying to accomplish by allowing states to establish employment requirements. It is certainly not fulfilling the vision of Lyndon Johnson. He sought to ensure the most vulnerable Americans could get health care. Not create unnecessary, politically driven hurdles to ensure they don't.